Planning for Better Health at the Regional Scale

CAMPO 2045 regional active transportation plan / Community Impact Newsletter

“Zip codes can determine your health,” said Kelly Porter, regional planning manager for the Capital Area Metropolitan Planning Organization (CAMPO), at the American Planning Association (APA) annual meeting in New York City. Given communities right next to other can have significant differences in overall health and even lifespans, it’s important to take a regional approach in order to reduce inequities. Representatives from three regional planning organizations — in Austin, Texas; Nashville, Tennessee; and San Diego, California — explained what they are doing to improve the health of their regions.

In the Austin metropolitan region, which totals more than 2 million, CAMPO has created the 2045 regional active transportation plan, the first-ever for the region, which is expected to be finalized this summer (see image from the draft plan above). With a federal grant, Porter said CAMPO was able to “double the average number of planning and design charrettes,” so they could “build the regional plan from the small community up.”

Setting up a WikiMap, they identified where the physical barriers were to more walking and biking, and went out in the communities with iPads loaded with surveys to find out where people actually wanted to walk and bike.

Layering over data about average trips, the number of households with children, and the underserved areas that “could really benefit from these projects,” CAMPO planners identified the hot spots to target first. “Our goal is to demonstrate the health benefits of these projects.”

They are now working on incorporating performance measures for even better outcomes. Porter admitted they are just in the early stages of looking at regional transportation through a health lens.

In the Nashville metropolitan region, which totals 1.8 million, the 2040 regional plan has identified 400 projects that will require some $8.5 billion to implement. Some 200 have been funded, explained Rochelle Carpenter, who leads the Nashville metropolitan area planning organization’s transportation and health program.

In this plan, some 77 percent either include sidewalks or bicycle infrastructure, up from just 5 percent in 2005. “Health became a new way to prioritize projects.”

Nashville area MPO Regional transportation plan / Nashville area MPO

Using both qualitative and quantitative analyses, they discovered the communities with the poorest health levels, and found those communities also had the high numbers of poor, unemployed, seniors, and people without cars. They expect their plan will reduce diabetes and cardio diseases by 3 percent and depression by 1 percent. From that statement, it sounds as if they will be measuring progress after projects to see if health outcomes do indeed improve.

Learn more about the elements of the plan, which includes $ 6 billion in new transit capital investments along with freeway bus rapid transit (BRT). Furthermore, the Southern Environmental Law Center has endorsed the plan.

Lastly, perhaps the most controversial planning process is in the San Diego metropolitan area, which has 3 million people. Carolina Ilic, senior regional planner with San Diego Association of Governments (SANDAG), said three behaviors — smoking, poor diet, and no exercise — contribute to four diseases — heart disease, diabetes, cancer, and lung disease — that account for more than “50 percent of deaths.” Live Well San Diego, a stakeholders group that includes planners and medical practitioners, and San Diego Forward: Regional Plan are efforts to reduce those behaviors, Ilic argued.

Under the plan, local governments in the region will roll out 275 miles of bicycle lanes, undertake hundreds of projects to improve access to transit and regional bike routes, and spend hundreds of millions on Safe Routes to Schools and new sidewalks and crosswalks. Some $200 million will be spent on a “regional bike early action program.” SANDAG gives local communities in its region grants, so they “take on a lot of the work.” Ilic said federal support was “instrumental;” the country received $16 million in grants and SANDAG $3 million, which they then mostly passed on to communities.

San Diego region bikeway / Keep San Diego moving

What Ilic didn’t mention at APA was that environmental and civic organizations and the state government sued to stop SANDAG’s regional transportation plan, because its emphasis on expanding freeways was deemed to run counter to state mandates to reduce greenhouse gas emissions, improve transit, and improve air quality. To address criticism, SANDAG later announced $200 million for its early action bicycle plan and then more for bike-ways over the next few decades.

Now, there’s a referendum to reform SANDAG. Read about support for the current structure for the group of 19 cities as well as the arguments for reform.

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